Individual provider Active NPI

Amber Deon McEachern, PHD

  • Psychologist
  • Albuquerque, NM
National Provider Identifier
1497784292
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1190 Issued in NM
Practice address
1400 Carlisle Blvd NE Ste F
Albuquerque, NM 87110-5667
Phone
(505) 503-1959
Fax
(505) 369-1851
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1016 KS
Mental Health Counselor 101YM0800X 8349 NE
Clinical Psychologist 103TC0700X PSY1190 NM
Psychologist 103T00000X 1190 NM Primary

Addresses

Primary practice location

1400 Carlisle Blvd NE Ste F
Albuquerque, NM 87110-5667

Mailing address

1400 Carlisle Blvd NE Ste F
Albuquerque, NM 87110-5667
Phone (505) 503-1959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180627001496 NM Practitioner - Clinical Psychologist 6901152313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1400 Carlisle Blvd NE
Suite F
Albuquerque, NM 87110-5667
Phone (505) 503-1959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1016KSMDMental Health Counselor
8349NEMDMental Health Counselor
PSY1190NMMDClinical Psychologist
1190NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
The Oak Bower, LLC CurrentSince Apr 1, 2018 Accepting new patients

Locations

1201 Eubank Blvd NE
Ste 1
Albuquerque, NM 87112
Phone (505) 361-1957

1400 Carlisle Blvd NE
Ste F
Albuquerque, NM 87110
Phone (505) 503-1959

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1497784292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CARLISLE BLVD NE STE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105667",
            "telephone_number": "505-503-1959",
            "fax_number": "505-545-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CARLISLE BLVD NE STE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105667",
            "telephone_number": "505-503-1959",
            "fax_number": "505-369-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEACHERN",
        "first_name": "AMBER",
        "middle_name": "DEON",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KS",
            "license": "1016",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "8349",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "PSY1190",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "1190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.